Recent Entries from Barbara Multer-WellinMovable Type Pro 4.382012-03-16T14:25:30Zhttp://www.kcet.org/user/profile/cns/feed/mt-cp.cgi?__mode=feed&_type=posts&username=yttcbmwWho Will Care for the Caregiver? tag:www.kcet.org,2012:/shows/yourturntocare//1772.436082012-03-16T21:25:30Z2012-07-02T02:12:19ZCurrently, about 10% of American women over the age of 65 have no children. That percentage will rise to 20% in the next decades when the nation's childless 40-year olds reach retirement age. Who will be the caregivers for the increasing number of the childless elderly?Barbara Multer-Wellinhttp://www.kcet.org/cgi-bin/mt/mt-cp.cgi?__mode=view&blog_id=1772&id=5703
Julie Phillips and Sonia Alvarado--caregivers featured in Your Turn to Care--will be without the option of having adult children care for them if the need arises. They are part of a growing demographic in the United States: childless women.

Currently, about 10% of American women over the age of 65 have no children. That percentage will rise to 20% in the next decades when the nation's childless 40-year-olds reach retirement age. This demographic and cultural shift sees no end in sight as the U.S. birth rate has dropped to the lowest rate ever recorded. Traditionally, it has been the duty of adult children to care for their elderly parents. But who will be the caregivers for the increasing number of the childless elderly?

We asked sociologist and author Dr. Ingrid A. Connidis of the University of Western Ontario who has written the book Family Ties and Aging.

Dr. Connidis: "If you don't have children, you are more likely to end up in some kind of nursing home or care facility when you are very old. However, in the work that I've done, it seems people without children worry more about not having help when they're old than they actually experience. Clearly, childless people have a tendency to be more fearful of the situation than reality would dictate. Childless people may often have more financial resources because they have not had the expense of rearing children so they may be able to pay for more support.

People assume having children will mean having social support later in life. And yet when you look at childless people, they are often more plugged in socially. Childless people are more likely to invest in their relationships with siblings, nieces and nephews and these relatives may provide support later in life. I'd like to emphasize that it is a very much give-and-take relationship. Over time, childless siblings tend to give a lot to their siblings who do have children and their nieces and nephew. It's a lifetime exchange.

Childless couples tend to be very dependent and to rely upon each other, probably more than couples with children. While someone still has a partner living, if that relationship has lasted into old age - you have a strong ally in that spouse.

People from the Baby Boomer generation are much more likely to have siblings and that that may well mean that brothers and sisters will turn to each other to provide support as they age. But the following generations will face additional complexities. There will probably be an even higher percentage without children and they will face a more complicated network of older relatives due to rising divorce and remarriage rates. Society has yet to figure out what responsibilities are owed to aging step parents. And younger people may also not have many siblings - another source of support that won't be there.

People who are childless have had a tendency to build up other relationship so they may be on the leading cusps of new trends in aging such as setting up community housing with their friends. They may be more innovative in making such arrangements because they've had the time to think that through.

We may have to be a little bit more innovative about the way we think about social support because people are now more likely to stay in the labor force into their 60s and beyond. Not as many women are staying home to take the role of caregiver. In general we have to rethink how we approach aging and getting through the later stages of life."

Ingrid Arnet Connidis is a Professor of Sociology in the Department of Sociology at the University of Western Ontario. Her work in the areas of family ties across the life course, adult sibling relationships, intergenerational relations, aging and policy implications has been widely published. Her current research focuses on family ties in mid and late life, including siblings, gay and lesbian family members, and step-ties.

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Balancing Work and Caregivingtag:www.kcet.org,2012:/shows/yourturntocare//1772.426252012-02-15T23:37:54Z2012-08-31T22:30:28ZThe time-consuming tasks of caregiving can make it very difficult to fulfill your responsibilities at work. You're not alone. More than 7 million Americans who work full-time are also providing intensive caretaking for a loved one.Barbara Multer-Wellinhttp://www.kcet.org/cgi-bin/mt/mt-cp.cgi?__mode=view&blog_id=1772&id=5703
As many of the caregivers profiled in Your Turn To Care know, holding down a job while caring for an elderly loved one can feel like trying to juggle meat cleavers. The time-consuming tasks of caregiving can make it very difficult to fulfill your responsibilities at work. You're not alone. More than 7 million Americans who work full-time are also providing intensive caretaking for a loved one.

According to a study conducted by the MetLife Mature Market Institute, the estimated total of lost wages, pension, and Social Security benefits for these caregivers is nearly $3 trillion.

Caregiving responsibilities may have a dramatic economic impact on both men and women through lost wages due to either reduced hours worked or leaving the labor force early and diminished Social Security benefits or private pensions.

One-third of caregivers leave the workforce or reduce their hours at work due to caregiving responsibilities.

At least 6 out of 10 caregivers have reported they had made some work-related adjustments as a result of their caregiving responsibilities.

An estimated 9% of the caregivers who were employed left the workplace as a result of their caregiving responsibilities; 3% took early retirement and 6% left work entirely.

An additional 10% of the employed caregivers reduced their hours from fulltime to part-time.

DEALING WITH YOUR EMPLOYER:

Be open and honest with your employer about your situation.

Let your company know you remain committed to your job and you need your benefits and salary.

Be prepared with realistic suggestions such as flex hours or work sharing that will allow you to fulfill your responsibilities as both an employee and a caregiver.

Your company may offer benefits such as an Employee Assistance program. Check with the Human Resources Department.

The MetLife study suggests "employers can help caregivers by providing workplace accommodations -- such as flex-time or family medical leave (FMLA) -- so that caregivers can continue to stay in the workforce while caring for a relative. Employers can encourage workers to use free resources, such as the Eldercare Locator online or by toll-free phone (1-800-677-1116) to find services that can help with caregiving."

Working while caregiving can present some challenging issues beyond what an employer can accommodate. Here are a few suggestions that can help to balance the work life and home life of a caregiver.

HELPING YOURSELF:

Limit phone calls from your loved one to emergencies only while you are at work.

You don't have to do everything yourself -- accept help from other family members and friends.

Deliberately partition your days into Work Time, Caregiving Time and Play Time.

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Recognizing Signs of Depression in the Elderlytag:www.kcet.org,2012:/shows/yourturntocare//1772.426222012-02-15T23:23:16Z2012-08-06T20:12:58ZOne of the things caregiver Gunn Leater feared most was that her 95-year-old father would become seriously depressed.Barbara Multer-Wellinhttp://www.kcet.org/cgi-bin/mt/mt-cp.cgi?__mode=view&blog_id=1772&id=5703
One of the things caregiver Gunn Leater (profiled in Episode 2 of Your Turn to Care) feared most when faced with the possiblility that her 95-year-old father could no longer attend an adult daycare program was that he would, once again, become seriously depressed.

Caregivers coping with their elderly family members are the most likely to be the first to observe changes in the condition of their patients. As the senior declines, physical changes are clearly noticed and steps are taken to remedy any new symptom. But the caregiver is also often the first person to notice more subtle changes in their emotional and mental disposition. Uniquely, they are the first line of defense of what can be an underlying but devastating condition: depression.

Depression in the elderly is a widespread problem that often goes unrecognized and untreated. Studies have shown depression affects more than 6.5 million of the 35 million Americans over the age of 65. Although older people do commonly experience challenges like the deaths of spouses and friends, the loss of their own independence, and chronic illnesses, depression is not a normal part of the aging process. Sadness and grief are normal, temporary reactions to the inevitable losses and hardships of life. Unlike normal sadness, however, clinical depression doesn't go away by itself and lasts for months.

Depression in the elderly is often hard to detect. It can be a side effect caused by many drugs routinely prescribed for the elderly. Common symptoms such as fatigue, appetite loss, and trouble sleeping may be ignored, or confused with other conditions that are common in the elderly. Clinical depression can be mistaken for physical illnesses such as thyroid disorders, Parkinson's disease, heart disease, cancer, stroke, or Alzheimer's Disease. Unrecognized and untreated depression can result in cognitive decline and even suicide.

Many elderly people and their caregivers do not know that depression is an illness that can be treated. The stigma of mental illness leaves some older people afraid to admit they are depressed. Some older people will not admit to feeling depressed, for fear that they will be seen as abnormal. Or they won't report their depression because they believe that feeling sad is "normal," or that nothing can be done about it. But, once depression is diagnosed, the prognosis is good. 80% of clinically depressed individuals can be effectively treated by medication, psychotherapy, electroconvulsive therapy (ECT) or any combination of the three.

SYMPTOMS OF DEPRESSION TO WATCH FOR:
If you notice any of these symptoms, make an appointment with a physician to rule out any physical causes and to review all medications:

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Being a Healthcare Advocate for Your Loved Onetag:www.kcet.org,2012:/shows/yourturntocare//1772.424882012-02-15T00:07:27Z2012-11-15T22:19:58ZGerontologist Mary Winners offers suggestions for how to be an effective healthcare advocate for your loved ones. Barbara Multer-Wellinhttp://www.kcet.org/cgi-bin/mt/mt-cp.cgi?__mode=view&blog_id=1772&id=5703
As seen in the first show, certified Gerontologist Mary Winners suggests to the Urquiza family that her sons accompany their mother when she visits her doctor. Acting as an advocate for their mother, they can insure all her needs are met. As founder of About Senior Solutions, a geriatric evaluation and referral company, Ms. Winners has over a decade of experience helping caregivers navigate the confusing maze of health care options. Below are Ms. Winners' suggestions to help caregivers be effective Healthcare Advocates for their loved ones.

Before the doctor's office visit:

Make sure you have an Advanced Health Care Directive for your loved one - that really empowers the caregiver to help - some doctors won't talk to you unless you have it.

If another friend or family member has decision-making authority with the Advanced Health Care Directive (AHCD), but you frequently take your loved one to appointments, sometimes a HIPAA Release can assist in communicating with the doctor.

Prepare for the doctor's visit - keep a log or journal of changes in behavior, pain levels, new symptoms - things that are alarming you - to discuss during the appointment.

Prepare questions in advance - know what you want to ask while you are there.

Prepare your loved one for the trip to the doctor, make sure you have plenty of time to get there to take the stress level way down.

Bring something to keep the patient occupied while in the doctor's waiting room, books, needlework, etc. Perhaps you can even tape your loved one telling stories about old times with the recorder you brought to tape the doctor's information.

During the doctor's visit:

Don't be afraid to ask for answers in plain English.

Ask how long before you should expect to see results when a medication is prescribed.

Ask the doctor to have your loved one qualified for home health care or hospice care when needed -- these costs are covered by Medicare and insurance and can provide wonderful extra support.

Ask the doctor if you can record the visit - so you can review all the information - it can be too overwhelming to try to remember it all.

Ask the doctor to tell you how to identify when your loved one is experiencing an emergency medical situation.

Ask for exact instructions about what to do and who to call when medical emergencies occur.

Talk to the doctor about any financial concerns you may have about paying for medication or out-of-pocket costs.

Doctors often address the adult child instead of the actual patient - make sure the doctor is talking directly to the patient, not you.

After the doctor's visit:

Using common sense is important, if you don't feel comfortable with what your doctor is telling you, ask for a second opinion, see a specialist or talk to your insurance company.

You have the right to all your medical records. It's a good idea to ask for records after a hospital stay or from a specialist to keep for yourself and provide to your primary (PMP-primary care physician). The organization may charge a small fee, but it's worth having a record.

Make sure any home care agency you use to hire in-home nursing help is insured and bonded and worker's compensation as well.

For the hospital or emergency room:

Make sure you are really clear in communicating to nurses and staff why you have brought your loved one into an emergency room - be very clear if you believe a heart attack or stroke is occurring.

Keep a copy of your loved one's medications, dosages and usage. If you don't know, make sure that you have a list of all of their medical conditions. Knowledge of these two items can mean life or death when emergency responders need to act fast.

Keep copies of your loved one's insurance to make things run smoother in an emergency.

You may be able to set up all of this information online through your healthcare company. Some companies provide a service to keep this information online, allowing you to access it anywhere in the world if you weren't home in an emergency.

If your loved one must be hospitalized, you absolutely must have his or her Advanced Healthcare Directive in your possession, especially if your loved one can't communicate for his or herself.

A hide-a-key or lock box for your loved one's home is important to have to avoid fire department personnel and paramedics having to break a window or door to get access. Some fire departments will record the location of a hidden key for an emergency.

Keep your phone number on your loved one's refrigerator so emergency responders can call you if needed.

Keep an emergency bag for yourself in the trunk of your car - just in case you wind up spending many hours in an emergency waiting room. Pack water, snacks, and a book.

These checklists will help any caregiver be the best advocate for a loved one.